99% Opening Reflection. For it was you who formed my inward parts; you knit me together in my mother s womb.

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1 This is the first of four studies on maternal health M AT E R N A L a n d C H I L D H E A LT H b y C o l l e e n W o o d For it was you who formed my inward parts; you knit me together in my mother s womb. Psalm 139:13 Opening Reflection Leader: O Lord, you have searched me, and known me. All: You know when I sit down and when I rise up; you discern my thought from far away. Leader: For it was you who formed my inward parts; All: You knit me together in my mother s womb. Leader: I praise you for I am fearfully and wonderfully made. All: Wonderful are your works Psalm 139 (various verses) Introduction I remember preparing for the birth of my 99% of all maternal dealths occur in developing countries first child. I arrogantly prepared my birth plan and brought it to the hospital. I filled out forms with my requests. I planned to do the whole thing as naturally as possible, although within the confines of a hospital. Then, I developed high blood pressure. It was mild and controllable, but still, concerns were raised. I would not be able to wait for labour to begin naturally, but would be induced on the due date. One intervention led to another, and after an emergency C-section, my son was born. Disapointing? Yes. But the reality was in the end, there was a healthy (although exhausted) mom, and a healthy baby. Maternal Health Study in Afghanistan 2 24 Glad Tidings in September/ October 2013 Study 3 Maternal Health in Malawi in January/Febrary 2014 Study 4 Maternal Health among Canada s Aboriginal People May/June 2014

2 Had I been a pregnant woman in a developing country, or even within certain parts of Canada, or pregnant during a different time in history, my journey might have been very different. The result might not have led to a healthy baby healthy mommy ending. My blood pressure might not have been monitored. It might have spiked putting both my life and the life of my child at risk. For many around the world, giving birth is risky, even life-threatening. Over the course of the next four studies, we will explore some of the issues of maternal health within Canada and around the world. Biblical Reflection Break into groups of 2 3 and give each group one of the following passages to explore: Genesis 21:1 7 Genesis 35: Samuel 4:19 22 Luke 1:7-14 Luke 1: Luke 2:1 7 (If your group is small, you can choose 2 3 of the passages and work through them together.) 1. What are 2 3 words that describe the birth story in your passage? 2. From this passage, or from other information you remember in the Bible, describe the mother in this passage? 3. What are some of the details missing from this story? 4. What feelings do you have about this birth story? Maternal Health Facts According to the World Health Organization, maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. i We tend to think of maternal health as a women s issue, but it is far from being a women s issue. This is a world issue. The death of a woman in childbirth is an issue for us all. These women are daughters, sisters, mothers, wives, nieces, and cousins. They are a part of their communities. These women contribute to the lives of so many male and female. If the infant survives, and the mother dies, that infant is three to ten times more likely to die in the next two years, and any of the women s remaining children become more vulnerable. These women contribute income to a household, sometimes the only July/August

3 Around the world, one woman dies every 90 seconds in pregnancy or childbirth. Amnesty International 26 Glad Tidings income. These women have the potential to change families and impact the world. Their children, too, have potential. These children, if they remain healthy, can attend school. These children, if they remain healthy, can become productive adults. These children, if they remain healthy, can change families, communities, countries, even the entire world. The good news is that maternal mortality rates have nearly halved since An estimated 287,000 maternal deaths occurred in 2010 worldwide, a decline of 47 per cent from However, these levels are far removed from the 2015 target that was named as one of the United Nation s Millennium Development Goals that were agreed to by 189 countries in the year ii And in some regions, the statistics have gotten worse. In the developing world, maternal death is the second leading cause of death among women of reproductive age. iii And infant deaths are also way too high. (Reducing child mortality rates was another of the Millennium Development Goals.) More than 3 million infants die in the first month of life, and one-third of those die on their first day. Not surprising, nearly all newborn and maternal deaths (98 and 99 percent, respectively) occur in developing countries where pregnant women and newborn babies lack access to basic health care services before, during, and after delivery. iv What might surprise you is that Canada has the second highest infant death rate of any country in the industrialized world. (The United States has the highest rate.) v Before delivery, antenatal (prenatal) care is essential to improving

4 Giving birth should be your greatest achievement not your greatest fear. Jane Weideman the survival outcomes of women and infants, and this care is often simple and inexpensive. This care should include screening high risk pregnancies to detect or treat complications, educating the mother (and when possible the father, as well), identification and management of infections, tetanus immunizations, and nutritional supplements. vi During delivery the leading causes of death are severe bleeding, infections, unsafe abortion, high blood pressure, and hypertensive disorders (pre-eclampsia and eclampsia). With minimal care, many of these deaths are preventable; most certainly, having a skilled health care professional present at a birth saves lives. For example, a simple shot of oxytocin administered to the mother by a health care professional following childbirth effectively reduces the risk of bleeding. Infections can be prevented through good hygiene, or treated if identified early by the health care professional. vii Finally, postnatal care is also essential. Again simple things, such as breastfeeding education, encouraging Kangaroo mother care (keeping the infant, especially pre-term infant close to encourage warmth and feeding), and infection prevention. viii In addition to the medical issues, there are some other issues at play here. Issues of gender inequalities do make a difference in maternal health outcomes. Educated girls tend to marry later and have their children later, reducing some of the issues that lead to mother and infant mortality. They also tend to be healthier. Family planning also saves the lives of mothers and babies. It helps women to avoid pregnancies when their bodies are too young or old, or to space their children at intervals that are healthier. ix Educating the men is essential in these issues to improve gender equality and allow for more educational opportunities for women. Together We Can! The WMS cares about maternal health. We have two Together We Can! projects that deal directly with maternal health issues. You can contribute to programs that improve the maternal health of women in Malawi, or the maternal health of women in Afghanistan. In addition, our third Together We Can! project supports work with Canada s Aboriginal Peoples by supporting the work of the Cariboo Ministries, and Saskatoon Native Circle Ministry. These ministries also have the ability to support young mothers and their infants. July/August

5 Poverty of course also affects maternal and infant mortality rates. Those in poverty do not have access to health care, and countries in poverty cannot provide the necessary care to their people. Issues of civil unrest can also affect care as individuals are unable to move freely around the country to easily access medical care. Those living in refugee camps are also at risk. Among Canada s First Nations Peoples there are similar challenges as for those in other parts of the world. In remote and northern areas there is the challenge of distances and transportation costs as well as few trained health care providers. These lead to higher mother mortality rates and we also know that Aboriginal children are more likely to die during the first year of their lives. x In 1999, the First Nations infant mortality rate the number of infants who die in the first year of life, expressed as a rate (per 1,000 live births) for that year was 8.0/1,000 live births (compared to 5.5/1,000 for Canada as a whole), with Sudden Infant Death Syndrome identified as the leading cause of death. (Health Council of Canada, 2005:45) To Think About: 1. Does maternal health matter to you? Why or why not? 2. How do you think it would feel to be a young pregnant woman in a rural part of the world with no access to medical care? What would your fears and hopes be for you and your unborn child? 3. How would you feel as the father of that unborn child? 4. Why is it important to improve maternal health around the world? How does it affect families, communities, and entire countries? Closing Prayer Creator God, we thank you for the miracle of birth. We pray now for the health and well-being of all women. We pray especially for pregnant women around the world. May they receive the care they need before, during, and after the birth of their children. We pray for young children around the world. May each have the care they need to thrive and develop into the people you have called them to be. We especially pray for young women and pray that they will have equal opportunities to thrive in this world. In Jesus name, we pray. Amen. 28 Glad Tidings

6 Additional activities 1. Choose a mother from 2 3 different decades to talk about their birth experience. What things have changed? What things remain the same? 2. Create a prayer poster on the issue of maternal health. This can be large enough to post on a bulletin board, or small enough for each member to bring home as a prayer reminder. Bring in magazines and invite individuals to cut out pictures of young women, young couples, and babies. On top of the paper, in bold letters write, Maternal Health it matters to me. Then glue the pictures you collected to create a mosaic of people. 3. Let your voice be heard. Write a letter to your MP and to Prime Minister Stephen Harper (pm@pm.gc.ca) to thank them for the current CIDA funding on maternal health, and encourage for it to continue or increase. i Maternal Mortality World Health Organization, May 2012, mediacentre/factssheets/fs348/en/index.html ii Goal 5: Improve Maternal Health, We Can End Poverty 2015, Millenium Development Goals, iii Fact File: 10 Facts of Maternal Health. World Health Organization, www. who.int/features/factfiles/maternal_health_facts/en/index.html iv Goal 5: Improve Maternal Health, We Can End Poverty 2015, Millenium Development Goals, p. 5. v Surviving the First Day: State of the World s Mothers Save the Children, 2013, p.3. vi Ibid. p.8 vii Maternal Mortality World Health Organization, May 2012, mediacentre/factssheets/fs348/en/index.html viii Surviving the First Day: State of the World s Mothers Save the Children, 2013, p.43. ix Surviving the First Day: State of the World s Mothers Save the Children, 2013, p.3. x Understanding the Improving Aboriginal Health in Canada. Health Council of Canada, 2011, p. 11. July/August